The aim should be to give the maxi mum of food that will sustain the pa tient, not the maximum amount that he can take. A good diet-list is: Milk, broths., soft-boiled eggs, junket, custard, the soft part of raw oysters, milk-toast, scraped chicken, scraped beef, chicken and rice boiled to a jelly, sago, tapioca, cornstarch, and animal jellies. The effects should be carefully watched. A.
H. Smith (Inter. Med. Mag., Apr., 1900).
The return to solid food in the stage of convalescence must be made with care, especially when the attack has been severe. Boiled custards, eggs lightly boiled, eaten with a small piece of thin bread and butter, are to be permitted first.
Some authors state definitely that solid food should not be given until a week or ten days after the temperature has remained normal throughout each day. Such rules should not always be adhered to. There are eases in which a moderate rise of temperature may exist for weeks, due largely to weakness, exhaustion, and want of elimination. The administration of solid food in small quantities will often relieve the exhaustion and enable the patient to gain sufficient strength to get out of bed. The writer is of the opinion that the general weakness from typhoid is unnecessarily prolonged in such cases by the withholding of solid I food. The fact that patients frequently sutler from n after tnlrincr solid r food may be explained on the ground that in a certain proportion of cases typhoid fever is a relapsing disease, and that the latter may not be due to the change of diet.
A more liberal diet in typhoid fever tried in 150 cases treated in seventeen months. In S4 cases deferveseenee was apparently unaffected by food. Five were first fed increasingly when the tem perature reached normal, and was fol lowed by slight irregularities in the tem perature. In 39 cases feeding was begun
when the temperature reached normal, and there was no subsequent rise. In 21 cases it was begun before the tempera ture reached normal, and was followed by a rise of temperature. In 13 eases feeding was begun before the temperature reached normal and was fol lowed by irregular fever, thought to be 11. AV. Moorehouse (Boston Sled. and Slug. Jour., Nov. 15, 1900).
The writer, along with other French an thorities—Albert Robin, for instance— has long been an opponent of the use of antipyretics in febrile processes. The predominating factor of typhoid fever is a paresis of all organic functions, and hyperthermia is not deemed a causative factor of the morbid effects ascribed to it, but itself a consequence of this paresis. The latter is primarily due to the influence of the infected blood upon the nervous system.
A free use of beverages is advocated. at least a quart of liquid being administered in the twenty-four hours. Milk is given the preference, owing to its nutritive and diuretic attributes, and may be drunk freely. as much as five pints a day being allowed by the writer wherever possible. It may be given in its normal state or boiled. If such free use of beverages should be objected to by the patient, enemata of boiled water or milk, re peated several times during the twenty four hours, should be administered in order to at least compensate for the quantity of beverage refused. Patients usually crave fluids, however. and Com pensative measures are seldom required. LiC-geois (•our. des Prat., Dee. 13, 1902).